Gastroesophageal Reflux Disease, commonly referred to as GERD, is characterised by the backflow of acidic or non-acidic stomach contents into the esophagus.

While experiencing occasional reflux—especially post-meal—is typical, individuals suffering from GERD experience either increased acid levels or more frequent reflux episodes. Moreover, these individuals may also show heightened sensitivity to stomach acid, even if the acid reflux level is within the standard range.

Recognising the Symptoms of GERD

Primary Symptoms:

  • Feeling of burning in the epigastric or mid-chest area, generally following a meal
  • Experiencing a sour or bitter taste sensation in the mouth or throat
  • Regurgitation of food back into the mouth or throat
  • Sensation of abdominal swelling in the epigastric region

Additional Symptoms

  • Non-specific chest discomfort unrelated to cardiac issues
  • Sustained changes in voice and chronic hoarseness
  • Persistent and unexplained cough
  • Issues with swallowing or a sensation of a lump in the throat
  • Dental issues like tooth decay and halitosis (bad breath)
  • Asthma symptoms unalleviated by standard medications

Causes and Risk Factors Contributing to GERD

Lower Esophageal Sphincter Abnormalities

This usually includes reduced pressure or increased frequency of opening, often induced by lifestyle choices like alcohol, smoking, or caffeine consumption.

Esophageal Abnormalities

This can make food move slowly down the oesophagus or stay longer, increasing reflux risk.

Stomach Abnormalities

Certain foods, like high-fat options and chocolate, can reduce stomach contractions, leading to prolonged food storage and increased risk of acid reflux.

Behavioural Factors

Consuming large meals, going to bed right after eating, or leading a stressful life can contribute.

Physical Conditions

Obesity and pregnancy can increase intra-abdominal pressure, contributing to GERD.

GERD Prevention Strategies

  • Limit or avoid foods and drinks that trigger acid secretion, like spicy foods, alcohol, or caffeinated beverages.
  • Opt for smaller, more frequent meals rather than large, infrequent ones.
  • Practise stress-management techniques such as sufficient sleep, exercise, meditation, and prayer.
  • Maintain a healthy weight to reduce abdominal pressure.
  • Avoid lying down immediately post-meal.

How GERD is Diagnosed?

  • Initial Diagnosis: Primarily based on patient symptoms and physical examination.
  • Advanced Testing: Required in cases of unresponsiveness to initial treatment or if warning symptoms are present, may include:
    • Gastrointestinal Endoscopy
    • Barium Swallow Test
    • Nuclear Medicine Imaging
    • Esophageal Manometry
    • Esophageal pH Test

Treatment Options for GERD

  • Lifestyle and dietary modifications
  • Prescription medications
  • Transoral Incisionless Fundoplication (TIF) procedure
  • Surgical Fundoplication

Possible Complications Associated with GERD

GERD can interfere with daily life due to the potential for esophageal irritation and inflammation. Severe cases can result in esophageal narrowing, causing painful or difficult swallowing. Although rare, there is also a risk of developing esophageal cancer.